HealthLeaders Media Finance - July 13, 2009 | What You Can Learn From 31 RAC Attacks View as a Webpage | Subscribe for Free
What You Can Learn
From 31 RAC Attacks

Michelle Ponte, Senior Editor-Finance

With so much noise about how to prepare for a RAC audit, maybe its best to go directly to the source for your intel: hospitals that have suffered a RAC attack. The VHA has mined RAC data from 31 hospitals that were part of the demonstration project, learning important lessons for the future. These hospitals paid back a total of $45 million to CMS. The main reason: failure to have appropriate documentation and coding that supported medical necessity. [Read More]
  July 13, 2009

Editor's Picks
Congress targets wealthiest earners for health reform funds
At this point, the question isn't will there be taxes to cover healthcare reform but who among the wealthy will have to take one for the team. Last week Senate Finance Committee Chairman Max Baucus (D-MT), withdrew his push for a tax on employer sponsored healthcare that would impact the middle class. Still, with the House and Senate looking to spend $1 trillion on healthcare reform, someone has to pay. That someone may be the top earners in this country. The House Ways and Means Committee is drafting legislation that would add a 3% surtax to households that earn more than $250,000. Committee members are also considering a Medicare tax on capital-gains income. [Read More]
Massachusetts health overhaul offers lessons for U.S. program
Lawmakers fear that a federal health plan as part of a reform package may encourage employee dumping. But so far this hasn't happened in Massachusetts, which in 2006 signed into law near universal healthcare coverage. Not only that, 150,000 additional state residents have become insured through their employers. Will the Massachusetts example serve as a bridge between the two extreme camps of the Republicans and Democrats? [Read More]
Draft bill threatens existence of physician-owned hospitals
Physician-owned hospitals seem to be losing the final battle in their fight to remain in existence. The American Hospital Association and other hospital groups cut a deal last week with President Obama to support healthcare reform in exchange for legislation that would prevent physician-owned hospitals from receiving Medicare Provider Numbers if physician-owners refer patients to their hospitals. Some say the move would wipe out physician-owned hospitals. Supporters say it is a necessary step in eradicating physician self-referral, which hurts community hospitals. [Read More]
Hospitals reach deal with administration
As we get closer to final reform legislation it seems everyone is making concessions. Two weeks ago drug makers gave up $80 billion in future revenue over the next decade. Now hospitals are putting cash on the table, agreeing last week to take a $155 billion hit primarily in Medicare and Medicaid payments over the next decade to help cover the rising cost of care. The agreement between leaders of three hospital associations, the White House, and the Senate Finance Committee also calls for another $40 billion to come from slowly reduced payments to hospitals for uninsured care. However, a public health plan is still of great concern for hospitals—especially if it pays Medicare rates. One industry observer said, "That would not be part of the plan." [Read More]
Finance Forum
Advantages of Small Business Contracting
Armed with a little bit of knowledge about some of the "ins and outs" of small business contracting under federal law, a hospital or physician group will be surprised at the number of potential business opportunities that they may actually be able to create for themselves. [Read More]
Finance Headlines
Democrats are at odds on financing healthcare
New York Times - July 10, 2009
Hospital's Pre-registration Efforts Pay Off in Collections
Dom Nicastro, for HealthLeaders Media - July 10, 2009
Cash-strapped Louisiana hospitals to work together to cut costs
New Orleans Times Picayune - July 9, 2009
Proposed rule cuts Medicare physician payment by 21.5%
Sg2 (free registration required) - July 9, 2009
About 45,000 Docs Qualify for Medicaid HIT Money
John Commins, for HealthLeaders Media - July 8, 2009
Tennessee Medical Association Sues Recovery Contractor
John Commins, for HealthLeaders Media - July 7, 2009
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From HealthLeaders Magazine
Time For 'Dr. Next'?
HealthLeaders July 2009 Generation X and its life-balancing, tech-oriented, team-playing doctors is taking over. But what kind of healthcare will they give us? [Read More]
Service Line Management
Prepare for the Cancer Boom
Aligning the right cancer care team and utilizing the appropriate technology is essential for maintaining a patient-centered service line. [Read More]
Money Talk

The Reading Hospital and Medical Center, West Reading, PA
Rating: Aa3
Outlook: Negative
Affected Debt: $137.4 million
Agency: Moody's Investors Service
Remarks: Outlook revised from stable due to poor financial results in the first nine months of fiscal 2009 and the expectation that the hospital will come in short of break even for the entire year. [Read More]
Audio Feature

Spine Strategies: Eula McKinney, director of the spine service line at the University of California San Francisco Medical Center, talks about the recession's impact on spine care and effective strategies for aligning with physicians to reduce costs. For more info, sign up for Service Lines Strategies 2009: Spine Care. [Listen Now]

July 22: Service Line Strategies Workshop 2009: Spine Care
August 20: Service Lines Strategies Workshop 2009: Gastroenterology
August 18: Advanced Service Line Marketing: New Orthopedics Growth Strategies
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